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Knee Injections for Arthritis Knee Pain: Do They Work?

Updated on October 2, 2011

If you've ever suffered with osteoarthritis knee pain then knee injections sound like a gift from 'The Heavens'. The question is do they really work? Let's examine the pros and cons of gel injections; which are one of THE most commonly prescribed treatments for knee pain.

Dr. Alexandra K. Schnee, D.C
Dr. Alexandra K. Schnee, D.C

Gel Injections for Knee Pain (AKA Rooster Comb Injections, Hyaluronic Injections, Hyaluronic Acid Injections, Hyalgen Injections)

What Do Hyaluronic Acid Injections Actually Do To The Knee Joint?

Gel Injections: Injections such as Synvisc™, Hyalgen™, Orthovisc™, Euflexxa™ are all types of knee injections. The theory behind these injections is that the viscous material that is injected between the knee joint helps lubricate it. It's like WD40 for the knee joint. They are used to help ease mild to moderate osteoarthritis in the knee joint.

Don't confuse these injections with cortisone injections which are steroids that help ease inflammation and swelling. Gel injections do NOTHING to relieve inflammation or swelling. Moreover, gel injections do NOT GROW back the cartilage in the knee joint, and they DO NOT ADD cartilage in the knee joint.

When Are They Recommended?

Hyaluronic acid joint injections are recommended for patients with mild to moderate knee osteoarthritis. Moreover, the FDA has approved its use for the temporary relief of osteoarthritis knee pain; 'when patients have failed to respond to other conservative non drug therapies and over the counter anagesics'.

How Often Are Gel Injections Administered?

Most of these injections are administered over a period of 3-5 weeks with one injection given every week. (Synvisc™just came out with Synvisc One™ which means that instead of having to get a total of three injections doctors can administer just one.)

How Long Will The Effects of The Gel Injection Last? Does it Work?

If the injection does provide knee pain relief it typically lasts for 6 months. Unfortunately, the controversy with these types of injections is that there's no real evidence that they work. Studies that have been published were performed on a small group of people and were funded by the pharmaceutical companies making the injections.

Are There Any Possible Side-Effects?

Hyaluronic acid injections can cause stiffness, redness, swelling, bruising, headaches, upset stomach, and limping. Moreover, those with allergies to egg products or bird feathers should NOT get these injections. Rare but serious reactions include: hives, difficulty breathing, closing of the throat, swelling of the face, lips or tongue. (This is not an all inclusive list. Please review the manufacturers website for a full disclosure of possible side-effects).

In addition, manufacturers have not determined the safety or effectiveness of multiple treatment cycles.

The Reality of Hyaluronic Acid Knee Joint Injections...

The few studies available indicate that those with 'mild osteoarthritis knee pain' notice improvement after a hyaluronic acid injection. The reality is though that most patients with mild pain, live with it, and do not get help.

Most patients seek some type of knee treatment when they have moderate to severe pain; when they can hardly walk, stand or sleep at night because the pain in their knees is unbearable. By the time a patient is this symptomatic they usually have moderate to severe osteoarthritis in their knees, AND in most cases have other issues in the knee complicating the problem.

It is very rare that I will treat a patient diagnosed with moderate to severe knee arthritis that doesn't also have one or more of the following conditions: a meniscus tear, bursitis, tendinitis, a baker's cyst, chondromalacia patella, etc...Unfortunately, gel injections are not indicated for patients with severe osteoarthritis or that have been diagnosed with these other types of knee conditions.

The Bottom Line...

I have consulted with hundreds of chronic knee pain sufferers over the years, and most of them have tried gel injections prior to visiting with me. Unfortunately, it's not very often that a patient will tell me that hyaluronic acid injections worked to relieve their knee pain.

In addition, FDA guidelines clearly state that gel injections should only be prescribed once all other conservative, non pharmacological measures have failed. So before you get a knee injection, why not try cold laser therapy, acupuncture, exercise and other types of non drug therapies that have proven to work for arthritis knee pain?

If you live in the Dallas- Fort Worth area and suffer with chronic knee pain visit

Dr. Alexandra K. Schnee, D.C. is a researcher, author, and consultant in the field of cold laser therapy for knee pain. She currently practices in Irving, Texas at the DFW Spine & Joint Center. She has been practicing since 2001, and has performed over 35,000 cold laser knee treatments. Her mission is to educate patients about alternatives to unnecessary knee surgeries, knee injections, and pain medication.

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    • drdspervez profile image

      drdspervez 6 years ago from Pakistan

      It's a nice and informative hub,I rated you up. :)